Question
Dr. Katz, About six months ago (I don't remember specifically when or any circumstances related to what occurred that might help pinpoint my problem unfortunately) I started noticing that my left big toe was numb. It was very sensitive to touch with that "tingling sensation" that you experience when a limb has "fallen asleep" and is beginning to regain feeling. I begin to experience what felt like electrical shocks in my toe as well. The irritation is mainly in the bottom part of my toe in the joint area and the right upper quadrant of the bottom of my toe. The electrical shock sensations would come and go periodically but it was intermittent. This past weekend those sensations started to occur constantly along with a feeling of itching deep within my toe that began to drive me crazy. I was unable to sleep due to the "shocks" and whenever anything touched my toe suddenly (like the sheet at night), it would send the electrical sensation throughout my foot. I had to put on a sock to provide a constant pressure that would make the toe again go numb and relieve the irritation. I saw a podiatrist yesterday who performed x-rays (were negative for anything) and he suggested that I had a neuroma and gave me a cortisone injection. I have read a lot about neuromas and my symptoms (especially the location of my problem on the big toe away from any other toes) makes it seem like it might not be the case. I do not wear high heels or tight shoes. I generally wear tennis shoes with good support and a few others all of which I would say have a wide toe box. I do however usually go barefoot while inside my home (as I actually hate wearing shoes). I am somewhat of a klutz and although I do not remember a specific trauma prior to the onset of my symptoms, I frequently hit my toes on furniture so can not rule out injuring my toe at some point. I was born with a club left foot that was corrected with casting and braces as a child but my foot does still roll to the inside and I usually wear out that portion of my shoes first so I know the inner part of my feet receive a great deal of pressure. I am supposed to return to the podiatrist in two weeks for a follow up and potentially another injection. My toe is still numb today-no different from before and although the electrical shocks have subsided somewhat I have had a couple of episodes of them today despite the injection. Any suggestions about what I should discuss with my doctor or possible other conditions that could be the source of my problems would be greatly appreciated as this is very disruptive, especially when it keeps me from resting. Thank you.

Answer
Hi Claudia,

It is not likely that you have a neuroma but more likely neuritis or damage yo the nerve.  This could have occurred from an injury or compression of your shoes.  The most important next step would be for your dr to use a small amount of anesthetic and determine exactly which nerve is affected.  In some cases an ultrasound or MRI could be useful to make sure that there is nothing compressing a nerve.  You should look at your shoes to see if they are pressing against the foot abnormally.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
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